House Republicans would let employers demand workers’ genetic test results
statnews.com
statnews.com
It very well may be what's best for society, but it's definitely not insurance.
Do you ....know what insurance is? Optimization based on feature of the population is not part of the definition. If a million people all paid into a pool that would cover any one of them if they got sick, and they all paid the premium, that would still be insurance.
Insurance has a societal benefit, in the sense that it spreads risk around the population as equitably as it can. I'm not required to have car insurance to drive in California because the nanny state wants to protect me from myself. I'm not required to have car insurance to drive in California because some insurance company donated a bunch of money to the relevant politicians. Both of those things might be true, but that's not why I have to have car insurance. I have to have car insurance to protect everyone else from me, and vice versa. The alternative is a world in which many more people have accidents and go bankrupt or sue each other for damages, and that's a worse world for everyone, even the people who never get in an accident. Insurance is like a low-pass filter for tragedies.
Health insurance is a similar situation. Access to preventative care, or just being able to see a doctor outside of an emergency room situation is a lot less expensive in the long run for everybody. Medicare and Medicaid costs (that all taxpayers eventually have to shoulder the burden of) scale with the health of the population on Medicare and Medicaid. Giving everyone the opportunity for health has a selfish reward as well as a humanitarian one, even if you don't care about poor people being able to see doctors when they have problems. It's much cheaper for everyone in the long run. This necessitates solutions in between the two extremes you presented.
If you want to pay extra for faster or 'better' treatment maybe you can get insurance for that.
As a society, the cost cutting measure should be based around buying in bulk and forming deals where a given area has at least enough coverage capacity contracted (presumably via some dutch-auction like mechanism) to cover projected needs.
If the point of insurance is to flatten the price of health care to something everyone can afford, then the cost is the sum of all health care expenditures for a period, not the health and precrime health of Joe Mightgetrectalcancer.
https://news.ycombinator.com/item?id=1288509
It only took a couple of years. See, it's easy to look at technology in the light of whatever the political climate is at the moment. But you should not be worried about what the present administration is going to do with it, you should be worried about the next and the one after that.
And your genes are not exclusively yours, your parents and children's genes are also exposed if you give away your genetic code.
Now employers are demanding genetic testing, next up insurance companies with some nice file sharing options to boot. It's all just a stroke of a pen somewhere away.
Look in the mirror. Odds are you're just as bad plus or minus a few %.
Being handsome, tall, white, heterosexual, male, aggressive, assertive, ruthless and remorseless can make you an exceptionally successful person within the business world. It's also not the sort of thing you'd want society made out of. Every day would be a struggle for survival for most, but for the tiny few that've fought their way to the top and can now have others do their fighting for them.
There's no room for things like wisdom, intelligence, for care or concern, for the pursuit of long-term goals instead of chasing short-term gains.
Management doesn't care that you've saved the company a billion over ten years if your project makes them come up 5% short on the Wall Street projections this quarter. Politicians don't care that they're destroying an institution that's saved millions of lives if they can get re-elected because they saved money. People don't give a shit if their neighbour gets thrown in jail because they're an "illegal" even when they're the one committing crimes: Dodging taxes, stealing from their workplace, bribing a school executive to admit their stupid kid...
It's a rough world out there, and the thing that's killing us is a lack of long-term vision.
What the hell has happened to this country.
And you can bet that these 'wellness' programs results, especially the genetic data will be filed for future use.
I don't think people realize the magnitude of the problem here. This is a Category 5 situation. They're pouring gasoline on important institutions that will take decades to rebuild, and the costs are going to be staggering.
Completely reversing the meaning of the word 'voluntary'.
Yes, the title is clickbait but the situation is a bit more serious than you make it seem.
Just compare the 2008 Republican Party platform [1] to where they stand today. A couple things that illustrate just how different the 2008 GOP was compared to today.
On climate change:
> Because Republicans believe that solutions to the risk of global climate change will be found in the ingenuity of the American people, we propose a Climate Prize for scientists who solve the challenges of climate change. Honoraria of many millions of dollars would be a small price for technological developments that eliminate our need for gas-powered cars or abate atmospheric carbon.
There are several other mentions of climate change in the 2008 platform. To the extent that dealing with climate change and economic growth are at odds, they wanted a balance close to growth than Democrats did (and do), but they knew that climate change did have to be dealt with.
On renewable energy:
> Alternate power sources must enter the mainstream. The technology behind solar energy has improved significantly in recent years, and the commercial development of wind power promises major benefits both in costs and in environmental protection. Republicans support these and other alternative energy sources, including geothermal and hydropower, and anticipate technological developments that will increase their economic viability. We therefore advocate a long-term energy tax credit equally applicable to all renewable power sources.
If you want to get banned from /r/republican, just wait until the next time cap and trade comes up, and someone says that it is a socialist liberal democrat commie approach, and point out that Ronald Reagan used it for the phaseout of leaded gasoline, and the first Bush used it for reducing the emissions responsible for acid rain, with overwhelming support from Republicans in Congress...and you will likely get banned from that subreddit for advocating anti-republican positions. Yup...RONALD REAGAN is anti-republican in today's GOP. (Well, his policies are...they never miss a chance to praise him or claim to be like him).
"Are you going to the gym? Did you sneak a cigarette in on Friday night? Did you have a chili dog or a salad for lunch)? Oh you won't tell us? Don't worry you don't have to. Okay we'll just slap a surcharge on your health insurance!"
What's also interesting is that in other western democracies, it's the left wing that's heavily fractured and damaged by infighting, with the right-wing generally able to get along and not get sidetracked by ideological purity. In the US, it seems to be the other way around.
I don't know if I agree. Whatever the platform says, the GOP have been active climate change denialists for decades (unless my memory is way off). They supported torture, the invasion of Iraq (along with many centrist Dems), the propaganda that Iraq was going well, and much more. They impeached a President for political reasons. They've been using dog-whistle politics to appeal to racists and their agenda since the 1960s (look up the Southern Strategy, or for a succinct explanation find the famous Lee Atwater interview).
Maybe it's a matter of degree (well, of course it is), but I don't think the degree of change in 2008 is that great. George W Bush, Dick Cheney, Don Rumsfeld, and the rest were considered pretty radical.
"Suit yourself, next year you won't even be given a choice"
Source: I work for a company that makes a wellness app.
A bonus to fill it out is the same as a penalty for not doing so.
The psychology is not 'better' it's just sneakier.
If you're employed as a test subject for a new cure to something getting a genetic workup seems very reasonable and is about the only time I'd acctually say yes to something like this. That's really the only case I can think of where this makes sense.
Why do companies actually want to do this? Do they think people will still work for them if they do?
It's not a surcharge if you don't plug it in, it's a discount if you do. Semantics...
"less terrible" is a phrase you should get to know.
If you think the government we have is a reflection of the popular will, you are deeply mistaken. Indeed, the whole point of gerrymandering, Voter ID, registration purges, and a host of other practices that have flourished in post-VRA era, is to ensure that the will of the majority is not embodied in the government.
We've never had a minority in power that was this formally unopposed, while being this hostile to the popular public interest. As far as the health and even survival of our republic's democracy goes, this is uncharted territory.
[1]: https://www.washingtonpost.com/news/the-switch/wp/2015/10/28...
It's about control.
Wellness, what a nice example of newspeak.
I think it is hard to extrapolate that into a guaranteed bleak future.
Even if the ACA is completely repealed it's hard to say where things will be in 8 years, never mind the forever.
And as for removing both Dems and Reps, how do you proposed to do that? They, together, control the whole government.
The only people with guns in any substantial numbers are the Trump supporters, the anti-Trump conservative Republican voters, and maybe a few violent radical leftists. The only ones there who are going to take a real stand against the government are the last ones, and they're 1) too few to make a real change, and 2) not people you want to side with anyway--people like Timothy McVeigh. In case you've forgotten, almost all the people on the left are anti-gun and consistently support anti-gun legislation. They're not going to be stockpiling arms and ammo. The ones who have are either happy with the current situation (Trump supporters), or somewhat unhappy but confident they'll be able to get politicians they prefer elected in the next election or two since they've already succeeded in getting many in Congress now ("mainstream" conservative GOP voters). It's only the leftists, liberals, progressives, etc. who are hopping mad, and they generally don't believe in gun ownership and certainly don't believe in civil war.
https://www.congress.gov/115/bills/hr1313/BILLS-115hr1313ih....
Relevant quotes:
"...workplace wellness programs and programs of health promotion or disease prevention offered by an employer that provide for more favorable treatment of individuals with adverse health factors as described..."
"...the collection of information about the manifested disease or disorder of a family member..."
But nothing about forcing genetic testing on employees.
In other words, it's mandatory.
I also like how they pre-emptively state that this is all in accordance with GINA when it really isn't.
The whole 'wellness' thing has fuck all to do with the wellness of the employees, it's all about case building and shifting responsibility onto employees.
If you expand the second quote, it reads:
"the collection of information about the manifested disease or disorder of a family member shall not be considered an unlawful acquisition of genetic information"
As the article stated, genetic testing isn't forced upon employees. If you don't do it, you might have to pay an increase of up to 50% for health insurance or.. if your employer doesn't sponsor healthcare, they can deduct your paycheck.
"No, it's considered voluntary. Except that if you don't comply with the voluntary wellness program you will end up with a steep financial penalty. In other words, it's mandatory."
"There's no difference between 'voluntary' and 'mandatory' if the penalty for not doing the 'voluntary' thing is so harsh that you can't afford to refrain."
--
You're right, there's nothing in this bill that explicitly forces your insurer to sequence your genome in the first place. HOWEVER, if a wellness program asked for your genome, and you denied it, then you would incur a heavy penalty. This is new.
Given that, here's selected text from the bill and its references (emphasis in capitals mine):
""" (HR. 1313, 2017) §1(3) in enacting the [ACA], Congress intended that employers would be permitted to implement health promotion and prevention programs that provide...SURCHARGES, PENALTIES, OR OTHER INDUCEMENTS...including rewards of up to 50 percent off of [sic] insurance premiums for employees participating... """
""" §3(a)(1)(B) ...any reward provided or offered by [such program] shall be less than or equal to the maximum reward amounts provided for by section 2705(j)(3)(A) of the Public Health Service Act (42 U.S.C. 300gg–4(j)(3)(A)) """
Here's that section from the referenced law:
""" 42 U.S.C. 300gg–4(j)(3)(A): [T]he reward for the wellness program...that requires satisfaction of a standard related to a health status factor...shall not exceed 30 PERCENT OF THE COST OF THE COVERAGE in which an employee or individual and any dependents are enrolled. ...[T]he cost of coverage shall be determined based on the total amount of EMPLOYER AND EMPLOYEE CONTRIBUTIONS for the benefit package under which the ...employee and any dependents are...receiving coverage. A REWARD MAY BE IN THE FORM OF...THE ABSENCE OF A SURCHARGE...or the value of a benefit that would otherwise not be provided under the plan. [Labor, HHS, and Treasury] may increase the reward available...up to 50 percent of the cost of coverage [at their option]. """
Now back to the bill:
""" (HR. 1313, 2017) §3(b) ...[T]he collection of information about the manifested disease or disorder of a family member SHALL NOT BE CONSIDERED AN UNLAWFUL ACQUISITION OF GENETIC INFORMATION WITH RESPECT TO ANOTHER FAMILY MEMBER...and shall not violate title I or title 16 II of the Genetic Information Nondiscrimination Act of 2008 (Public Law 110–233). """
The gist is this: Employers can "offer" programs with a "reward" for participating that is "you won't get a 30 percent surcharge" on the full bill, including both employer and employee costs, including costs for your entire family (i.e., likely a much higher amount than the employee's premium contribution). For the employee to "voluntarily" participate, the employer can require genetic testing, even if such testing is "with respect to" another family member -- and such testing is deemed by this law to expressly not be a violation of protections under PL 110-233. Oh, and by the way, the government can simply declare at any time that the surcharge rises to 50% from 30%.
See:
http://www.snopes.com/genetic-testing-bill/
There is nothing in this bill that empowers your insurer to sequence your genome in the first place.
It's easy to read the bill in its entirety, along with all the referenced sections of law, and see where the Snopes analysis is incorrect or does not sufficiently embody the imaginations of the lobbyists behind the bill.
Snopes:
""" The bill...does not in and of itself require employees to enroll in such programs. But it notes that according to the Patient Protection and Affordable Care Act, employers could reduce annual health insurance premiums by up to 50 percent for employees who did take part. """
Bill:
""" ...employers would be permitted to implement health promotion and prevention programs that provide incentives, rewards, rebates, SURCHARGES, PENALTIES, OR OTHER INDUCEMENTS related to wellness programs... """
""" ...A reward may be in the form of...THE ABSENCE OF A SURCHARGE... """
The Snopes analysis is incorrect. The bill specifically permits employers to "surcharge" everyone who does not participate, and "reward" those who do by relieving them of the surcharge. Such relief would be based on participation in the "wellness program". The bill even uses the very weak term "related" to allow substantial latitude in the design of these programs and their penalties and rewards.
Snopes:
""" A spokesperson for the committee told us...[i]f a worker chooses to voluntarily participate in an employee wellness program, they would then typically participate in a health risk assessment. This has long been the case for employee wellness programs, including employee wellness programs promoted by the Affordable Care Act, and it would continue to be true for employee wellness programs under H.R. 1313. """
The spokesman here is attempting to justify the bill by somewhat defensively comparing it to provisions of the ACA, of whose repeal this bill would be a component. Workers will "choose to voluntarily participate" because they'll receive a memo from their employer stating that their costs will jump substantially if they do not.
Snopes:
""" A May 2016 ruling by the Equal Employment Opportunity Commission (EEOC) stated that premiums could be cut by 30 percent for individuals and 60 percent for couples who enrolled in such programs. But under the new bill, premiums could be cut by up to 50 percent. """
Bill:
""" [T]he reward...shall not exceed 30 percent of the cost of the coverage...[and]...may be in the form of...the absence of a surcharge...[which]...[Labor, HHS, and Treasury] may increase...up to 50 percent. """
(EDIT: Note that the language here is "cost of the coverage", not "premiums" -- vague drafting which is probably designed to allow a newly maximal interpretation of "cost".)
This speaks for itself, and what I've elided for clarity does not change the meaning, as you can verify yourself with a quick read of the bill. HR 1313 allows the option of a "negative reward" of 50% for "voluntary" non-participants, and furthermore allows genetic testing (not specifically genome sequencing, although nothing in the bill seems to prevent this possibility) of those who do "voluntarily participate" as a precondition for such participation.
The bill blithely disclaims conflict with genetic nondiscrimination law; such disclaimer would almost certainly be held invalid if tested.
Actually, no, a later enactment explicitly stating that things it allows are not prohibited by an earlier enactment, by that explicit statement, limits the earlier enactment.
From the other side it demonstrates both the promise and the peril of triangulation. On the one hand you back your opponent into a corner. On the other hand, you end up making your opponent's proposal the new "consensus centralism" and force the public discourse so far in their direction that the "crazy extremist" position becomes the new rational opposition.